经跗骨窦切口与外侧L形切口钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的疗效分析

Effect analysis of plate internal fixation via tarsal sinus incision and lateral L-shaped incision in the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures

目的分析SandersⅡ、Ⅲ型跟骨骨折患者采用经跗骨窦切口与跟骨外侧L形切口钢板内固定治疗的临床疗效。方法回顾性选取2017年9月至2021年3月池州市人民医院收治的62例SandersⅡ、Ⅲ型跟骨骨折患者,按照手术方式不同分为对照组和观察组,每组31例。其中,观察组采用经跗骨窦切口复位微型钢板内固定手术治疗,对照组采用跟骨外侧L形切口钢板内固定手术治疗。对比分析两组患者的手术相关指标、术后12个月跟骨Bohler角、Gissane角以及Marland足部功能评分,并比较术后并发症发生情况。结果62例患者均接受术后随访,随访时间13~16个月。术后6个月所有患者骨折均愈合,平均骨折愈合时间3~6个月。观察组患者的手术时间、手术切口分别为(53.1±10.3)min、(4.3±0.9)cm,明显短于对照组[(84.0±15.3)min、(11.1±1.2)cm],术后疼痛评分为(1.8±0.5)分,明显低于对照组[(3.2±1.1)分],差异均有统计学意义(P<0.05)。两组患者术后12个月Bohler角、Gissane角、Maryland足部功能评分比较,差异均无统计学意义(P>0.05)。观察组患者并发症发生率为6.45%,明显低于对照组(22.58%),差异有统计学意义(P<0.05)。结论经跗骨窦切口复位微型钢板内固定手术对SandersⅡ、Ⅲ型跟骨骨折患者造成的创伤较小,骨折复位及内固定强度效果明显,术后并发症发生率降低,足部功能恢复较快。

Objective To analyze the effect of plate internal fixation via tarsal sinus incision and lateral calcaneal L-shaped incision in the treatment of Sanders Ⅱ and Ⅲ calcaneal fractures.Methods A total of 62 patients with Sanders type Ⅱ and Ⅲ calcaneal fractures admitted to Chizhou People’s Hospital from September 2017 to March 2021 were selected and divided into control group and observation group,31 patients in each group.Control group used lateral calcaneal L-shaped incision plate internal fixation and observation group used 31 patients with tarsal sinus incision reduction and micro plate internal fixation.The surgical treatment effect,calcaneal Bohler Angle and Gissane Angle at 12 months after operation,and Marland foot function score at 12 months after operation were compared and analyzed between the two groups.Results All 62 patients were followed up for 13-16 months.All the fractures healed 6 months after operation,and the average fracture healing time was 3-6 months.The operation time and incision of the patients in the observation group were(53.1±10.3)min and(4.3±0.9)cm,which were significantly shorter than those in the control group[(84.0±15.3)min and(11.1±1.2)cm],the postoperative pain score was(1.8±0.5)points,which was significantly lower than that in the control group[(3.2±1.1)points],the differences were statistically significant(P<0.05).There was no significant difference in Bohler Angle,Gissane Angle and Maryland foot function scores between the two groups at 12 months after operation(P>0.05).The incidence of complications in the observation group was 6.45%,which was significantly lower than that in the control group(22.58%),the difference was statistically significant(P<0.05).Conclusion Transtarsal sinus incision reduction and micro plate internal fixation is a minimally invasive surgery,which causes less trauma in patients with Sanders type Ⅱ and Ⅲ calcaneal fractures,and has obvious effect on fracture reduction and internal fixation intensity.The incidence of postoperative complications is reduced,and the foot function recovery is faster.